Anna Flaxis

Huh? I have no idea what you are asking.

Hi Steve123, At face value, this is a very disturbing story. Some questions I have are: Are you certain this patient has no indications for Vanco? Are you certain that the physician was being "honest" vs. making a sarcastic, jaded comment? If the situation is exactly as you describe and there is nothing more to it, then I would have a couple of suggestions. You could take this up the chain of command and talk about your concerns, starting with your charge nurse and going up the chain from there as needed. Alternatively, you could skip that process if your work environment is such that you suspect that it will be futile and/or you fear retaliation, and make an anonymous report to risk management/the hospital's patient safety officer. Good luck!

Again, what harm does swallowing a nipple ring do? Sure, there is potential for harm, but most of the time, they pass without incident.

What harm have you seen swallowed nipple or navel rings cause? I'm trying to understand this, because it's not a button battery or a magnet. It's a small foreign body that will most likely pass with no adverse sequelae. Am I missing something? I'm really more curious than anything...

Totally normal! If trial by fire works for you, you'll do well. Give it six months to a year before you don't feel like a complete idiot, cry your whole drive home, and lie awake at night re-living all of the things you did wrong. You'll do great!

Sounds like a real cluster, and you were thrown under the bus. I'm glad the attending apologized.

I would have made this patient a 2, but not because of the reason cited by your supervisor. Your supervisor is playing a dangerous game making triage decisions based on how often the patient presents. The reason I would have made this patient a 2 is that she had vitals in the "danger zone" and a potentially high risk condition, and did not require immediate life saving intervention.

I think it's appropriate to have patients expressing SI/HI dress down and to remove personal belongings from the room. This can include removing jewelry if the jewelry is of a nature where it could be used to cause harm to self or others. However, it is hard for me to imagine how the average nipple or navel ring could harm anyone or interfere with the plan of care in any meaningful way. As an ER RN, this is not a hill I'd choose to die on, and I'd err on the side of protecting the patient's rights.

What??? Why not? It is completely within your scope of practice as a professional R.N. to provide this information. Granted, I might advise taking the family members aside and gathering more information about why they feel the need to deceive their loved one, but I would also inform them that as a competent adult, she has a right to know, and that as a professional R.N., your duty is to your patient.

I think it really depends on the way this is implemented. I see nothing wrong with an action plan, per se. If the director is participating in a supportive manner to assist the employee in coming up with an action plan, assisting with the formatting, suggesting references, etc., then it could be a potentially constructive intervention. If, however, the director is not providing any guidance, support, or assistance, and is letting the employee flail about in stormy seas, then no, I'd have to say it's not something I'd advocate for. And, I do not think the employee should be required to do this on unpaid time. It should be on paid time and in a supportive environment. Otherwise, it is punitive and may be actionable by the labor union if there is one, or if not, then by the State Labor Board.

Words of wisdom: It's normal to feel like a complete incompetent idiot as a new grad. Take your co-workers' "ambushings" as opportunities for improvement. Pick yourself up, dust yourself off, and come back and do it again the next day.

Well, then there ya go. I would suggest applying to an agency, but I have really strong feelings about new grads taking agency work, so I won't. Good luck to you!

Hi, I've been on both ends of this. More than once when I was a CNA did the RN say within my earshot that "The CNA will do that" when they were in the freakin' room. More than once have I changed the soiled bed of a dependent patient *by myself*. Does that always feel good? Well, I only know how it felt to me when I was a CNA. As an RN, I've had to pass on assisting with ADLs because of other more pressing issues. If you let it bother you, it will eat you up. Just do your best to provide the best patient care you are able, and if the RN won't help you, f*** 'em. Just remember what kind of RN *YOU* want to be (if that is a goal of yours). Take care!

If you've given it a chance for six months but still hate it, you're never gonna love it. Just my opinion. Start looking for work elsewhere.

"I get the feeling that she is socially starved." Ya think? Maybe find a way to compliment her once in a while. Find something about her that you appreciate and tell her so. Humor her kitty pics, but hold her accountable for unprofessional behavior. Remember that you never know what battles others might be facing, and try to be forgiving.